Perinatal psychiatry

Question 1

How long does the ‘baby blues’ usually last?

Answer 1

3-5 days postpartum, generally resolving within 10 days

Question 2

How long must Sx last to be diagnosed with postpartum depression?

Answer 2

> 2 weeks

Question 3

What tool can be used int he Dx of postpartum depression?

Answer 3

EPDS - Edinburgh Postnatal Depression Scale - 10 questions administered within 8 weeks of delivery

Question 4

What are the RFs for postnatal psychosis?

Answer 4

1. PMHx
2. Pre-existing psychiatric disorder
3. FHx

Question 5

All psychiatric drugs should be prescribed at their lowest effective dose, particularly in pregnancy, but why might an increased dose of a psychiatric drug be required in pregnancy?

Answer 5

Maternal blood volume increases by over 30% in pregnancy

Question 6

What risks to the infant does lithium present when taken during pregnancy?

Answer 6

Cardiac malformations - esp. Ebstein’s anomaly

Question 7

What is Ebstein’s anomaly?

Answer 7

The septal and posterior leaflets of the tricuspid valve are displaced towards the apex

Question 8

How should serum levels of Lithium be checked during pregnancy?

Answer 8

Every 4 weeks until week 36 of pregnancy, and weekly thereafter

Question 9

What risks to infant does BZDs present when taken during pregnancy?

Answer 9

1. Cleft-lip/palate
2. Withdrawal in the infant
3. ‘Floppy baby syndrome’ - esp. when given in the 3rd trimester

Question 10

Why is clozapine contraindicated in pregnancy AND breastfeeding?

Answer 10

Due to the risk of agranulocytosis in foetus/neonate

Question 11

Which SSRI is associated with cardiac malformation when taken in the first trimester?

Answer 11

Paroxetine